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Post-employment benefits for associates (Details 2) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Pension plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation at beginning of period $ 23,066 $ 22,179  
Current service cost 372 336  
Interest cost 222 330  
Past service cost and settlements (102) (168)  
Administrative expenses 24 24  
Remeasurement losses/(gains) arising from changes in financial assumptions 1,166 1,791  
Remeasurement (gains) arising from changes in demographic assumptions (28) (193)  
Experience-related remeasurement losses/(gains) 159 184  
Currency translation effects 1,810 283  
Benefit payments (1,264) (1,256)  
Contributions of associates 186 169  
Effect of acquisitions, divestments or transfers (9) 49  
Benefit obligation at end of period 25,602 23,066  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period 19,810 18,838  
Interest income 166 257  
Return on plan assets excluding interest income 1,318 1,656  
Currency translation effects 1,620 304  
Novartis Group contributions 464 420  
Contributions of associates 186 169  
Settlements 15 (193)  
Benefit payments (1,264) (1,256)  
Effect of acquisitions, divestments or transfers 2 39  
Fair value of plan assets at end of period 22,317 19,810  
Funded status (3,285) (3,256)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Limitation on recognition of fund surplus at beginning of period (65) (68)  
Change in limitation on recognition of fund surplus (incl. exchange rate differences) 16 7  
Interest income on limitation of fund surplus (2) (4)  
Limitation on recognition of fund surplus at end of period (51) (65)  
Net liability in the balance sheet at end of period (3,336) (3,321) $ (3,409)
Other post-employment benefit plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation at beginning of period 746 1,073  
Current service cost 11 13  
Interest cost 20 29  
Past service cost and settlements 1    
Remeasurement losses/(gains) arising from changes in financial assumptions 40 76  
Remeasurement (gains) arising from changes in demographic assumptions (13) (9)  
Experience-related remeasurement losses/(gains) (132) (22)  
Currency translation effects (7)    
Benefit payments (33) (30)  
Effect of acquisitions, divestments or transfers (1) 1  
Benefit obligation at end of period 632 746  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period 134 119  
Interest income 4 3  
Return on plan assets excluding interest income 4 10  
Novartis Group contributions   74  
Novartis Group contributions (20)    
Contributions of associates 0    
Benefit payments (33) (30)  
Effect of acquisitions, divestments or transfers   (2)  
Fair value of plan assets at end of period 89 134  
Funded status (543) (612)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Net liability in the balance sheet at end of period $ (543) (612) (954)
Discontinued operations [member] | Pension plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation, Discontinued operations at beginning of period   (662)  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period   (424)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Net liability in the balance sheet at end of period   0 238
Discontinued operations [member] | Other post-employment benefit plans      
Defined benefit plan, change in benefit obligation [roll forward]      
Benefit obligation, Discontinued operations at beginning of period   (385)  
Defined benefit plan, change in fair value of plan assets [roll forward]      
Fair value of plan assets at beginning of period   (40)  
Defined benefit plan, change in limitation on recognition of fund surplus [roll forward]      
Net liability in the balance sheet at end of period   $ 0 $ 345